Individual
DR. ROMAL I GANDHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12251 S. 80TH AVENUE, PALOS HEIGHTS, IL 60463
(708) 923-5869
(708) 923-5859
Mailing address
12251 S. 80TH AVENUE, MED STAFF OFFICE SUITE 1630, PALOS HEIGHTS, IL 60463
(708) 923-5173
(708) 923-5018
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-109071
IL
208M00000X
Hospitalist Physician
Primary
036.109071
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109071
—
IL
01
—
F40081751
MEDICARE PTAN
IL
Enumeration date
05/06/2006
Last updated
06/21/2017
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